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State v. Beaulieu

Supreme Court of North Dakota

September 13, 2018

State of North Dakota, by and through Workforce Safety and Insurance, Appellee
v.
William Beaulieu, Appellant and CMG Oil & Gas, Inc., Respondent

          Appeal from the District Court of Mountrail County, North Central Judicial District, the Honorable Douglas L. Mattson, Judge.

          Jacqueline S. Anderson, Fargo, ND, for appellee.

          Amanda J. Welder, Bismarck, ND, for appellant.

          OPINION

          Crothers, Justice.

         [¶ 1] William Beaulieu appeals from a district court judgment reversing an administrative law judge's ("ALJ") order awarding benefits and affirming prior Workforce Safety & Insurance ("WSI") orders. The ALJ's order finding Beaulieu had a fifty percent permanent partial impairment rating was not in accordance with the law and not supported by the evidence. Therefore, the ALJ erred in awarding permanent partial impairment and permanent total disability benefits. We affirm.

         I

         [¶ 2] In September 2011 Beaulieu was injured while working for CMG Oil & Gas, Inc., when the truck he was in rolled on its side. In October 2011 WSI accepted his claim for benefits for injuries to his head, right shoulder and lumbar spine, and paid associated medical expenses and disability benefits. His treating physician reported on January 10, 2013, that Beaulieu reached maximum medical improvement.

         [¶ 3] In February 2014 Dr. Jane Stark conducted a commercial driver license ("CDL") evaluation of Beaulieu, documenting that he was indefinitely unable to drive under the CDL requirements. In April 2014 Dr. Stark again saw Beaulieu and assigned him "a 50% permanent total disability," stating:

"The patient has significant and objective neuropsychological impairments that affect his daily functioning and ability to operate in a work environment. Due to the neuropsychological changes, especially with respect to cognition and integrated functioning, it does appear that he has significant changes which prohibit his performance of his normal role of a truck driver and of employability."

         In September 2014 WSI issued an administrative order awarding partial disability benefits based on a retained earnings capacity of zero. Beaulieu requested a hearing, asserting he was "entitled to permanent total disability benefits including a permanent impairment evaluation to assist in determining his eligibility for permanent total disability."

         [¶ 4] In March 2015 Dr. Terry Young performed a neuropsychological evaluation of Beaulieu and was asked to provide a permanent impairment rating. Dr. Young opined Beaulieu's deficits sustained as a result of the September 2011 work incident "triggered an exacerbation of a pre-existing neuropsychological condition causing disability beyond its normal manifestation and progression." Dr. Young assigned a ten percent permanent impairment for the neuropsychological condition. In April 2015 WSI issued a notice of decision, stating it did not have the necessary information to decide his permanent total disability status. Beaulieu requested reconsideration.

         [¶ 5] In May 2015 WSI's permanent impairment auditor sent Dr. Young a letter asking whether apportionment of impairment was appropriate because of a 1971 traumatic brain injury. In a June 2015 response "[b]ased on the Guides to the [Evaluation] of Permanent Impairment6th Edition" ["AMA Guides"], Dr. Young apportioned five percent of Beaulieu's neuropsychological deficit to the September 2011 work incident and five percent to neuropsychological conditions that existed prior to 2011.

         [¶ 6] In July 2015 WSI issued a notice of decision, based on Dr. Young's initial report of ten percent whole body impairment, denying permanent impairment benefits because the impairment was below the fourteen percent threshold for an award. On July 31, 2015, WSI issued an amended notice of decision, denying permanent impairment benefits based on Dr. Young's opinion of five percent neuropsychological impairment related to the work injury. Beaulieu requested reconsideration, asserting the impairment determination failed to consider other compensable conditions.

         [¶ 7] In September 2015 WSI issued an administrative order denying permanent impairment benefits based on a five percent whole person impairment as Dr. Young opined. Beaulieu requested an administrative hearing before an ALJ. In December 2015 WSI issued an order denying permanent total disability benefits because he did not meet the statutory definition for permanent total disability.

         [¶ 8] WSI and Beaulieu's counsel agreed to another permanent impairment evaluation relating to other body parts. In May 2016 Dr. Douglas Martin examined Beaulieu and issued his report providing an impairment rating "based upon the principles of the American Medical Association Guides to the Evaluation of Permanent Impairment, Sixth Edition." Dr. Martin assigned Beaulieu a "5 percent whole person impairment rating from the traumatic brain injury central nervous system abnormality with the 3 percent impairment rating from the Facial Disorder/Disfigurement Table" for a combined "8 percent whole person permanent partial impairment rating." WSI's audit of Dr. Martin's report determined Beaulieu had a combined eight percent whole person impairment, and in June 2016 WSI issued an amended order denying permanent impairment benefits.

         [¶ 9] An administrative hearing before an ALJ was held on October 6, and December 12, 2016. The ALJ heard testimony from Beaulieu's brother, Mike Beaulieu; Dr. Martin; and WSI's Chief of Injury Services, Tim Whalen. In February 2017 the ALJ issued an order reversing WSI's orders that denied permanent impairment and permanent total disability benefits. The ALJ, primarily relying on Dr. Stark's opinion, found the greater weight of the evidence established Beaulieu had a fifty percent permanent impairment rating, was entitled to permanent ...


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